Induction Therapy in Half-Haplotype Low Risk Kidney Transplant Patients: Impact on Acute Rejection, Graft Survival, Infection and Surgical Complications at 3 Years

Objective: This retrospective study discusses the need for induction therapy in half haplotype low immunological risk kidney transplant patients. Material and Methods: Records of 70 adult kidney transplant patients were reviewed with 3 years follow up. All patients were half haplotype matched with their living related donors and had PRA < 20% and DSA 0% when available. We divided the patients into 2 groups based on the induction therapy used during kidney transplantation. Hence, we compared 25 patients who were treated by induction therapy (anti-IL2 receptor antibodies or anti-Thymocyte globulin) (Group I) with 45 other patients who did not get any induction therapy (Group II). The primary endpoints comprised the rate and the severity of acute rejection episodes as well as the 3-year graft function and survival. Secondary endpoints contain: the frequency and the type of infections and the surgical complications at 1 year as well as the amount of malignancy and the patient survival at 1, 6, 12 and 36 months after kidney transplantation. Baseline demographic characteristics including: donor age, recipient and donor gender, cause of kidney disease, dialysis duration, donor to recipient CMV matching were similar in the two groups. Whereas, significant differences existed between the 2 groups in relation to: recipient age, pre-transplant hemoglobin blood level, anti-CMV prophylaxis regimen and maintenance immunosuppression. Results: We did not find any significant difference between the 2 groups regarding the length of hospital stay, the rate and severity of acute rejection, the rate of CMV infection, the occurrence of delayed graft function and the rate and type of surgical complications at 1 year. Furthermore, the patient and graft survival as well as the serum creatinine levels upon discharge and at 1, 3, 6, 12 and 36 months were also comparable. Nevertheless, the rate and type of out of Hospital infections and 1-year infection rate as well as the treatment cost were significantly higher in Group I. Conclusion: Induction therapy might not be desirable in low-immunological risk half-haplotype kidney transplant patients